Student Program Request Form (HA/CA)
Please complete this form at least 2 weeks prior to the event date. A health promotion staff member will respond within 3 business days to confirm the capacity to complete your request.
Your UWO Email
Student organization representative
Your Residence Hall or Organization
Your RHD/Supervisor or Staff Advisor
Brief description of the event or program
Date of Program
Start Time of Program/Event
Band aids (various sizes)
Dental Dams (oral sex barrier)
Feminine hygiene products
Sleep Kit (includes brown gift bag, lavender sachet, eye mask, earplugs, and sleep education materials)
Stress Kit (includes brown gift bag, fidget toy, stress ball, coloring page, box of 4 crayons, dark chocolate, and stress relief tea bag))
Other first aid or wellness supplies
Approximately how many people do you anticipate attending this program/event?
Provide any additional relevant information if needed.
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This form was created inside of UW Oshkosh.